Rapid Pneumococcal Evolution in Response to Clinical Interventions

• Type of Material: Article
• Authors: Nicholas J. Croucher, Wellcome Trust Sanger Institute; Simon R. Harris, Wellcome Trust Sanger Institute; Christophe Fraser, Imperial College London; Michael A. Quail, Wellcome Trust Sanger Institute; John Burton, Wellcome Trust Sanger Institute; Mark van der Linden, Rhein Westfal TH Aachen; Lesley McGee, Centers for Disease Control and Prevention; Anne von Gottberg, University of Witwatersrand; Jae Hoon Song, Sungkyunkwan University; Kwan Soo Ko, Sungkyunkwan University; Bruno Pichon, Health Protection Agency Centre for Infections; Stephen Baker, Oxford University; Christopher M. Parry, Oxford University; Lotte M. Lambertsen, Statens Serum Institut; Dea Shahinas, University of Toronto; Dylan R. Pillai, University of Toronto; Timothy J. Mitchell, University of Glasgow; Gordon Dougan, Wellcome Trust Sanger Institute; Alexander Tomasz, Rockefeller University; Keith Klugman, Emory University; Julian Parkhill, Wellcome Trust Sanger Institute; William P. Hanage, Imperial College London; Stephen D. Bentley, Wellcome Trust Sanger Institute
• Language: English
• Date: 2011-01-28
• Publisher: AMER ASSOC ADVANCEMENT SCIENCE
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: 2013 American Association for the Advancement of Science.
• Final Published Version (URL): http://dx.doi.org/10.1126/science.1198545
• Title of Journal or Parent Work: SCIENCE
• Volume: 331
• Issue: 6016
• Start Page: 430
• End Page: 434
• Grant/Funding Information: This work was funded by the Wellcome Trust.
• Keywords: SEROTYPE 19A; EMERGENCE; DISEASE; SEQUENCE; TRANSFORMATION; Multidisciplinary Sciences; INTERCONTINENTAL SPREAD; 23F CLONE; RESISTANT STREPTOCOCCUS-PNEUMONIAE; ANTIBIOTIC-RESISTANCE; UNITED-STATES; Science & Technology - Other Topics; Science & Technology
• Research Categories: Health Sciences, Immunology; Biology, Virology

Abstract

Epidemiological studies of the naturally transformable bacterial pathogen Streptococcus pneumoniae have previously been confounded by high rates of recombination. Sequencing 240 isolates of the PMEN1 (Spain23F-1) multidrug-resistant lineage enabled base substitutions to be distinguished from polymorphisms arising through horizontal sequence transfer. More than 700 recombinations were detected, with genes encoding major antigens frequently affected. Among these were 10 capsule-switching events, one of which accompanied a population shift as vaccine-escape serotype 19A isolates emerged in the USA after the introduction of the conjugate polysaccharide vaccine. The evolution of resistance to fluoroquinolones, rifampicin, and macrolides was observed to occur on multiple occasions. This study details how genomic plasticity within lineages of recombinogenic bacteria can permit adaptation to clinical interventions over remarkably short time scales.